Strengthening Native American families can help improve children’s health

Strengthening Native American families will help improve their children's health—that's the premise behind a research study targeting 3-, 4- and 5-year-olds and their caregivers on the Pine Ridge Reservation in South Dakota.

The one-year pilot study will determine whether an evidence-based Strengthening Families Program for preschoolers can improve the children's social, emotional and nutritional health.

Assistant nursing professor Mary Isaacson, who specializes in Native American health care, and professor Marylou Mylant of the South Dakota State University College of Nursing are in charge of the project. Mylant's research focuses on the mental health of children, adolescents and young families and attachment.

While doing health assessments in 2010 at the Red Shirt School near Hermosa, Isaacson identified a dramatic increase in the number of children who were overweight or obese.

"We are trying to lift up the parents in their roles as caregivers and teach the children how to best respect that," said Mylant.

The research is made possible through a nearly $100,000 grant from the National Institute on Minority Health and Health Disparities of the National Institutes of Health through the Collaborative Research Center for American Indian Health.

Adapting program to community
Mylant and Isaacson worked with Red Shirt school personnel and community leaders to adapt the Strengthening Families Program to their specific needs while incorporating the Lakota culture.

"They [school staff] go above and beyond what happens in other places, which is a real gift," Mylant said. When the head start program was discontinued, Red Shirt School added a preschool curriculum.

"The school is a protective factor for these children and families," Mylant added. Approximately 80 students in preschool through eighth grade attend the rural reservation school.

"The community has to own it and decide what will work best for them," Isaacson said.

Modeling behaviors
Beginning in October, the first intervention group—10 3- and 4-year-olds and their caregivers—started meeting each Friday afternoon. A second group began the 14-week program in February.

Caregivers and children come together for a meal, receive separate instruction and come back together for a combined activity. For instance, parents look at positive ways of helping their family be happier by learning to get along better, including how to talk about and understand each other's feelings, Mylant explained.

Children might then talk about foods that they like and don't like and how they react when their caregivers serve these foods. Mylant encourages them to be open to new foods.

When the caregivers and children come together for a joint activity after the meal, a puppet show might demonstrate how to promote and reward positive behaviors.

Children learn lessons about "doing nice things, saying nice things for what you like and ignoring what you don't like," Mylant said. That applies to both foods and relationships.

In a lesson emphasizing fruit and vegetable consumption, Red Shirt Village elders teach the children and caregivers Lakota words, such as green for lettuce or blue for blueberries. A Lakota blessing is also provided by the elders before each meal and after the family session or close of the weekly group.

If this intervention proves successful, the program can then be used in other Lakota reservation schools.